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CSON IM1 > tissue integrity part two > Flashcards

tissue integrity part two Flashcards

1
Q

Pressure ulcer

A

also called pressure injury, localized injury to skin and/or underlying tissue

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2
Q

where are pressure ulcers usually at

A

bony prominences

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3
Q

how do pressure injuries occur

A

prolonged pressure for a prolonged period of time

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4
Q

pathophysiology of pressure ulcers

A

prolonged period of time –> stops capillary flow to tissue –> deprives tissues of oxygen and nutrients –> cell death and tissue necrosis

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5
Q

pressure intensity

A

amount of pressure

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6
Q

pressure duration

A

length of time pressure is exerted on skin

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7
Q

tissue tolerance

A

ability of tissue to tolerate the presure

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8
Q

tissue tolerance factors

A

nutrition, perfusion, co-morbidities, condition of soft tissue

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9
Q

shearing forces

A

when skin adheres to a surface and skin layers slide in the direction of body movement

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10
Q

moisture

A

Excessive moisture that leads to skin breakdown

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11
Q

what is staging based on

A

NPUAP

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12
Q

NPUAP

A

national pressure ulcer advisory panel

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13
Q

deep tissue injury

A

purple or maroon localized area of discolored intact skin or blood filled blister

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14
Q

what does a deep tissue injury indicate?

A

damage of underlying soft tissue from pressure or shear

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15
Q

Stage one

A

intact skin, non-blanchable

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16
Q

stage two

A

partial-thickness loss of dermis, shallow open ulcer

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17
Q

stage three

A

Can see subcutaneous tissue, full thickness skin loss

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18
Q

stage four

A

extends to muscle, bone, or supporting structures, full thickness loss

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19
Q

unstageable ulcer

A

Full-thickness loss but actual depth can not be seen because view is obstructed

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20
Q

untreated ulcers may lead to

A

cellulitis

21
Q

most common complication of pressure ulcers

A

recurrence of tissue breakdown/repeat pressure ulcers

22
Q

signs of infection of pressure ulcers

A

swelling, redness, and foul odor

23
Q

what can cellulitis lead to

A

sepsis leading to death

24
Q

leukocytosis

A

high white blood cell account

25
Q

pressure ulcer prevention

A

Redistribution of pressure, dry skin, repositioning, turning schedule, nutrition and fluid intake

26
Q

greatest treatment for pressure ulcers

A

Prevention

27
Q

prevent (1)

A

deterioration

28
Q

reduce (2)

A

factors that contribute to pressure and skin breakdown

29
Q

prevent (3)

A

infection

30
Q

promote (4)

A

healing

31
Q

prevent (5)

A

recurrence

32
Q

what do you document for a pressure injury

A

stage, size, location, exudate, infection, pain, and tissue appearance

33
Q

MASD

A

moisture associated skin damage

34
Q

IAD

A

incontinence associated dermatitis

35
Q

MARSI

A

medical adhesive related skin injury

36
Q

lower extremity ulcers

A

related to changes in blood flow to lower extremities or chronic disease

37
Q

arterial ulcers

A

caused by problems with blood flow in arteries, ischemia, nutrition deprivation

38
Q

venous leg ulcers

A

blood cannot flow upward from veins in the legs

39
Q

wound margins and thickness of venous leg ulcers

A

irregular, superficial

40
Q

wound margins and thickness of arterial ulcers

A

even, deep

41
Q

diabetic ulcers

A

caused by peripheral neuropathy, fissures in the skin, and decreased ability to fight infection

42
Q

wound margins of diabetic foot ulcers

A

even

43
Q

cellulitis

A

deep inflammation of subcutaneous tissue caused by enzymes produced by bacteria, often after break in the skin

44
Q

antibiotic resistance

A

the emergence of resistance to antibiotics

45
Q

can viral infections be treated with antibiotics?

A

No

46
Q

how does antibiotic resistance happen

A

taking too many antibiotics OR not finishing your prescription

47
Q

psoriasis

A

plaque formation with varying degrees of severity

48
Q

tell-tale signs of psoriasis

A

silvery scales

CSON IM1 (28 decks)

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